title: Coping as a mediator in the relationships of spiritual well-being to mental health in black women with type 2 diabetes.
abstract: OBJECTIVE
  Examine coping as a mediator in the relationships of spiritual well-being to mental health in Black women with type 2 diabetes (T2DM).
  
  
  METHODS
  Using a cross-sectional design, data were collected from a convenience sample of 45 Black women with T2DM. Measures of coping strategies, spiritual well-being (religious and existential well-being), and mental health, as measured by diabetes-specific distress (DSED), were collected. Bivariate findings informed mediational, trivariate model development.
  
  
  RESULTS
  Religious well-being was significantly related to cognitive reframing (CR) coping strategies (p = 0.026) but not DSED (p = 0.751). Existential well-being was significantly related to CR (beta = 0.575,p < 0.001), direct assistance (DA) coping (beta = 0.368, p = 0.006) and DSED (beta = -0.338, p = 0.023). Although CR (beta = -0.305, p = 0.021) and DA (beta = -0.262, p = 0.041) had significant bivariate associations with DSED, the relationships were not significant when existential well-being was controlled. However, the relationship of existential well-being to DSED was mediated by specific CR and DA strategies that were associated with DSED to varying degrees -"I came up with a couple different solutions to the problem" (beta = -0.301, p = 0.049); "I came out of the experience better than I went in" (beta = -0.308, p = 0.061); and "I talked to someone who could do something concrete about the problem" (beta = -0.272, p = 0.078).
  
  
  CONCLUSIONS
  Findings indicate that diabetes care address spiritual well-being, both its religious and existential components, in Black women with T2DM.
authors.affiliation: New York University College of Nursing, New York, NY 10003, USA. kelley.newlin@nyu.edu
authors.forename: Kelley
authors.initials: K
authors.lastname: Newlin
authors.forename: Gail D
authors.initials: GD
authors.lastname: Melkus
authors.forename: Mark
authors.initials: M
authors.lastname: Peyrot
authors.forename: Harold G
authors.initials: HG
authors.lastname: Koenig
authors.forename: Emily
authors.initials: E
authors.lastname: Allard
authors.forename: Deborah
authors.initials: D
authors.lastname: Chyun
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D044383:Black People / Q000523:psychology*; D003237:Connecticut; D003430:Cross-Sectional Studies; D054521:Cultural Competency / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D005086:Existentialism / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011209:Power, Psychological; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000523:psychology; D012803:Sick Role; D029181:Spirituality; D055815:Young Adult; D001741:Black or African American